Bush Seeks Limits In Malpractice Suits

May 13, 1991|By New York Times News Service.

WASHINGTON — In his first response to calls for changes in the nation`s health care system, President Bush will send to Congress this week a proposal to help control the fastest-rising part of medical costs: malpractice litigation and the insurance to cover it.

According to a draft of the proposal made available by White House officials, states would be encouraged to adopt limits on the amounts that malpractice victims can collect for pain and suffering, to set up mediation systems for resolving disputes and to strengthen medical licensing boards, among other things.

States that fail to go along would lose some of the federal payments they receive under Medicare and Medicaid programs, which pay for health care for the elderly and the poor.

Though it is limited to malpractice reforms, the proposal is the administration`s first significant one in the area of health care.

White House officials say the plan will decrease the cost of medical care, chiefly by cutting the amount doctors will have to pay for insurance and allowing the doctors to charge less for services. They said the plan would also increase access to care, noting that some doctors, for example, have stopped delivering babies because of the high cost of insurance.

An expert on malpractice expressed concern that the Bush proposal addressed doctors` worries about large awards but not patients` worries about malpractice itself.

Democrats said in interviews in the past several days that the chances of passing the president`s proposal as it stands are quite small. But the proposal, they added, puts the administration into the debate and could be folded by other health care measures.

The chief provisions of the proposal, which would take effect in 1995, would press states to:

- Set limits on the amount of money malpractice victims can collect for their ``pain and suffering`` while leaving actual damages from medical bills and future lost earnings without specified limits.

- Require that money paid to victims not be paid in a lump sum, but in periodic payments over years. This means the doctors and hospitals sued, or their insurance companies, would hold onto the money as it earns interest, thus reducing the amount they ultimately must pay.

- Require states to establish alternative ``dispute resolution mechanisms`` like arbitration or mediation, which victims must appeal to before going to court.

- Require states to strengthen their medical licensing boards, to establish guidelines for what treatments are appropriate when patients come in with certain problems.